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Objective: To compare the performance of anti-granulocyte scintigraphy with those of widely used prognostic indices (such as DAS28, anti-CCP, early MRI imaging). Methods: Twenty-five patients with early arthritis were enrolled into the study. Following the review of clinical data and the evaluation of disease activity, we performed MRI imaging of the hands, anti-granulocyte scintigraphy, and determined anti-CCP positivity. The relationship between the changes of MRI scores and the above prognostic factors were analyzed statistically. Results: At baseline, values were as follows: DAS28 3.86±1.19, CRI 0.15±0.12, MRI erosions and synovitis scores 25.11±12.82 and 4.32±4.02 (respectively), the ratio of anti-CCP positivity was 7/12 (58%). After the follow-up period of 13.6±2.52 months, erosion and synovitis scores were 43.11±22.23, and 5.32±6.16, respectively (p=0,001 and p=0,015). The occurrence of new erosions was correlated with baseline erosion score (k=0.523, p=0.022) and anti-CCP positivity (p=0.021). The relationship between CRI and baseline synovitis score was strong (=0.518, p=0.023), whereas it was weak only between the former and baseline erosion score (=0.402, p=0.08). Conclusion: As shown by this study, potential markers for predicting subsequent destructiveness in early RA include MRI and anti-CCP testing, primarily. 99mTc labeled anti-granulocyte joint scintigraphy is appropriate for the objective and quantitative appraisal of disease activity. [ABSTRACT FROM AUTHOR]

Background: Mycophenolic acid (MPA), a selective inhibitor of lymphocyte proliferation, has lately been used to improve renal function and prolong graft survival in renal transplanted patients. Still, there is no consensus considering the recommended dosing and the therapeutic range of MPA. Methods: To estimate the safe therapeutic range of MPA, its plasma level and indicators of kidney function were measured in 216 patients (138 male, 78 female, age 46±12 years) 67±46 months after transplantation. Besides MPA, patients received cyclosporine (Group A, n=122) or tacrolimus (Group B, n=77). Seventeen patients (Group C) were treated with MPA in combination with everolimus or sirolimus. Plasma MPA was measured by enzyme inhibition assay. Results: In the whole study group MPA level increased with the dose of MPA (p=0.013). MPA level was below the therapeutic range in 40% (Group A) and 45% (Group B) of patients, respectively. MPA was 1.9±1.56 mg/L in Group A, 2.4±1.69 mg/L in Group B. In Group A MPA level increased and cyclosporine decreased with the progress of renal disease. Conclusions: Increasing MPA/cyclosporine ratio at more severe stages of chronic kidney disease was tolerable for the patients and rejection could be avoided. Tubular damage detected by urinary N-acetyl-β-D-glucosaminidase did not correlate with the MPA level. [ABSTRACT FROM AUTHOR]

To detect and follow-up the metabolic status of patients with alkaptonuria (AKU), urinary homogentisic acid (HGA) was measured by gas chromatography. These results were close to values we obtained by colorimetric method (linearity: up to 700 mg/l, detection limit: 1 mg/l, within-run imprecision (CV): 1.2% at 100 mg/l HGA, 4.9% at 10 mg/l, between-run CV: 6.8% at 100 mg/l). To determine urinary reference ranges of HGA, 84 healthy children (age: 2 months-18 years) were divided into five age groups. HGA and creatinine were measured in their morning urine. Statistical analysis proved that urinary HGA/creatinine ratio is age-dependent. The ratio is relatively high between 1 and 6 years of age, with large scatter (upper limit of reference ranges given as mean + 2 SD: 5.5-7.2 mg/mmol = 0.03-0.04 mmol/mmol creatinine), and it decreases with age. Approximately at the age of 7 years, HGA/creatinine ratio becomes constant, and later it is similar to the adult value (upper limit: 2.8 mg/ mmol = 0.017 mmol/mmol creatinine). We monitored a patient during her 1-5th year of life, and her urinary HGA was 80-200 times higher than the upper limit of the age-matched reference ranges. The measurement of HGA supports the decision for starting restricted protein diet and is useful for the evaluation of the effectiveness of therapy. [ABSTRACT FROM AUTHOR]

Serum N-acetyl-β-D-glucosaminidase (NAG; EC 3.2.1.30) is a hexosaminidase and may be a predictor of vascular injury, e.g., in infant respiratory distress syndrome, pneumonia, broncho-pulmonary dysplasia and necrotizing enterocolitis. To estimate the new diagnostic prospects we have modified our urinary NAG assay. In this sensitive colorimetric micro-assay, VRA-GlcNAc was used as a substrate. In the present study the age dependence of serum NAG activity was investigated in newborn babies, infants (1–24 months), children (2–18 years) and adults (19–80 years). Serum NAG activity was found to be age-dependent; it is higher in early childhood (11–59 U/l) but decreases to a constant value at the age of 1–2 years. After the age of 2 years it is similar to adults' NAG (10–30 U/l). In pediatrics age-matched reference ranges must be taken into consideration. [ABSTRACT FROM AUTHOR]